Whitewater Rafting: Therapy for PTSD?

If my plastic brain (see my last two blogs) has been stamped with some ugly combat images, why not drop a couple of pleasant, high-adrenaline memories on top of the bad ones?

That's the premise that X Sports 4 Vets is based on, and the program based out of Missoula, Mont., seems to be helping a number of vets. It features riverboarding, rock climbing, sky diving, and other extreme sports. You can learn more about the program at http://xsports4vets.org/

One form of therapy is whitewater rafting down the Lochsa River, a 20-mile stretch of wild and scenic river in eastern Idaho that boasts 25 class 3-4-and-5 rapids. I floated the Lochsa a few years ago, and it was a once-in-a-lifetime thrill for me.

"When I got out on the river, it was like team-building," says Brandon Bryant, an Air Force vet. "It was exciting without the inherent danger of going out in the field."

During five and a half years in the Air Force, Bryant fought the war from a cubicle in Las Vegas, where he was the co-pilot of a UAV (unmanned aerial vehicle) Predator. "When we shot missiles, I was the one who guided them into the target," he told me.

But the first deaths he witnessed were American soldiers returning from a mission in Iraq just after dawn. "We saw something that looked like a buried IED (improvised explosive device) in the road, but we couldn't stop them. The first vehicle went over it. Then the second went over it. It exploded, and everyone died," he says. "I was 19 at the time and I felt guilty, as though I was responsible for the deaths of our military members. That's when I knew I would never be the same again."

In one sense, it was like being a bombardier in Vietnam. In another, it was a lot worse.

"We flew the Predator by satellite in Iraq and Afghanistan, gathering intelligence for a week or so unless our guys were under attack," he says. "Then we found out where the bad guys were shooting from, and we would drop bombs on them. I could see the aftermath of every strike."

When Bryant returned home, he was diagnosed with 100 percent PTSD (post-traumatic stress disorder). He carried a lot of guilt and a lot of anger at people who had little regard for their own lives or the lives of others. And he isolated himself from most civilians, including his own family, who couldn't understand what he'd been through.

That changed on the river.

"Being in combat, that adrenaline rush comes with worry," says Bryant. "Deep in your gut, you're not sure if something bad is going to happen until it's all over. But out on the river, you know that if something bad happens, you've got a lot of guys around to help you. So there's no risk of dying."

I'm with Bryant to a point, but when I floated the Lochsa, I knew there was a risk of death. I felt we were challenging a huge natural element, something that was dangerous but not malevolent, something that could kill you but didn't necessarily want to.

There was a lot of teamwork involved in pulling the oars together strongly so we could power the raft over a curl of boiling whitewater without it flipping backward and dumping us into the frigid water.

And when one of my friends, sitting in the seat directly in front of me, got washed into the river, I jumped to my feet, pushed an oar at him, pulled him over to the side of the raft, grabbed the shoulder pads of his life vest, lifted him as high as I could and then fell backward, dragging him on top of me into the raft. What a rush that was!

Adrenaline is a huge part of floating the Lochsa River, just as it's a huge part of surviving combat. But we now know that adrenaline also plays a large role in enhancing memory for emotional events, so that voluntary exercise that involves an adrenaline rush may facilitate the "learning" of safety and the consolidation of new, positive memories.

Paul Gasser, a neuroscientist at Marquette University in Milwaukee, says that just the exercise from extreme sports reduces stress. "Exercise is at least as effective an antidepressant as any of the pharmaceutical treatments," he told me recently.

Gasser and his colleagues have been tracking adrenaline and a hormone called cortisol in both humans and laboratory animals. Adrenaline is secreted into the bloodstream instantly by the adrenal gland during "fight-or-flight" situations because it enhances quick bursts of energy for survival purposes, heightened memory function, and a lower sensitivity to pain. Cortisol, an important stress hormone also secreted by the adrenal gland, acts more slowly to facilitate adaption and recovery after stress.

Neurologists have found that PTSD patients appear to have lower baseline cortisol levels and a decreased cortisol response to stress. This means that these patients appear to have lower levels of the hormone that is critical for relaxing after stress. They say that this may be a risk factor for PTSD, and increasing that cortisol response could facilitate recovery.

Both adrenaline and cortisol are produced during periods of voluntary exercise. Elevating the adrenaline levels during voluntary exercise and the cortisol levels after exercise appears to help the body recover better after stress, says Gasser.

Steve Hale, who deployed to Iraq in 2004-05 with the Washington National Guard, can speak first-hand to the benefits of the X Sports 4 Vets program. "I gave it a shot and really saw the value of it," he told me. "I got a connection between me and the experience and between me and the other guys. It was almost like being born again."

Combat had changed his perspective. "I really believed in the mission until the first bullet skipped across the hood of the vehicle," he says. "Then it was all about self-preservation and helping your buddy get home, too."

When he got home, he wasn't exactly sure who he was, except that he wasn't the same person he had been before Iraq. Like Bryant, Hale was depressed and tended to isolate himself from others. But that made it hard for him to understand that he wasn't alone with his problems. Working and bonding with other vets has given him a chance to see how they are resolving their common problems, says Hale.

And then there's that adrenaline rush that Gasser talks about.

"You're on the edge to where it could be dangerous, but it's not," says Hale. "People talk about numbing, but this makes you feel again. It's good to have a pucker factor and your heart race. It's a good positive outlet, not like getting drunk and getting into fights which is how we used to cope. But you can't sustain that morally or legally. This is constructive versus destructive.

"Every time I get out on the river, I come home with stories and big pleasant memories," says Hale. "It does me a lot more good than the pills they've been throwing at me."

Eric - I loved your comment about the river being dangerous, but not malevolent, able to kill you, but not necessarily trying to kill you.

I can understand the vet's outlook in regards to the danger factor, since he had faced people who were trying to kill him, but, I hope, whoever is leading these PTSD patients on these activities is not sugarcoating the inherent danger.

Having received hundreds and hundreds of adrenaline doses due to rafting over the past four decades, I am confident rafting will have a net positive effect. The bonus is that paddle rafting is ideal for building camaraderie and teamwork as well.

I applaud those who are making this program happen. Getting high on life, teamwork and your own adrenaline beats the hell out of alcohol and worse.

Thanks James. The vets who are running the program seem like a pretty competent bunch, and I think you're in a pretty secure position if you've got a dozen combat vets around you. But you're right -- any rational person is going to be nervous in that situation.

I find this premise relevant to my own experience. I grew up with a mother who was rather severely borderline pd and narcissistic pd, with obsessive-compulsive pd traits. My childhood was like living in a mine field, never knowing when my mother would explode with rage. I and my younger sister were subjected to chronic, intense emotional abuse and sometimes physical abuse. I think I developed complex-post traumatic stress disorder as a result, and possibly Avoidant Personality Disorder as well, or at least several symptoms of that disorder.

The key point: as a child and teen, I craved to go on roller coasters and see horror movies. Perhaps on some subconscious level I recognized that I needed to "reprogram" myself, or replace the trauma inflicted on me with the conscious choice of experiencing healthy, safe excitement.

So, I buy the idea that layering exciting but safe fun on top of trauma-inflicted damage (ptsd) is a valid therapy. Seems valid to me.

Thanks for the comment Annie. I suspect your self-diagnosis is correct -- counselors estimate that 10 percent of the civilian population suffers from PTSD as a result of abuse and crime. And layering positive thrills over the trauma seems to reduce the intensity of the original memories. So if you loved rollercoasters as a child, I bet you'd really love rafting!

Oh really, I had never known that rafting can do so much beneficial things to PTSD patients. I used to think that rafting is only as a adventurous sport. I would like to know furthermore good information about rafting.